Many Teens, Families Unaware They Qualify for Insurance 

By Houkje Ross


Closing the Gap, Adolescence • November/December 2000


Teenagers and young adults are the least likely of any age 

group to have health insurance coverage, according to U.S. 

Census Bureau statistics. Approximately 14 percent of adolescents ages 10 to 18—4.2 million teens—are not covered by any 

form of health insurance. That’s about 1 in 7 uninsured adolescents. 

For low-income and minority adolescents, the proportion is even 

higher. 

In 1997, President Clinton signed into law the State Children’s 

Health Insurance Program (SCHIP), which provides health insurance 

to uninsured children of low-wage working parents. All states now 

have an SHCIP plan in place and are working to expand the program 

to reach more children and teens. Health and Human Services Secretary Donna E. Shalala recently approved a proposal by Hawaii to 

further expand its program and provide health insurance through the 

Hawaii SCHIP program to thousands of additional children. State 

officials expect this expansion of their SCHIP program to cover nearly 

5,300 children by September 2001. But recent reports indicate that 

many parents still are not aware of the program and states have been 

working hard to promote the program. 

“Most of the promotion for SCHIP is for younger children. Here 

in California I see a lot of advertisements for SCHIP that have pictures 

of small children, not teens” said Claire Brindis, DrPH, executive 

director of the National Adolescent Health Information Center. As a 

result, many families may not know their teen qualifies for insurance 

under the program. 

Dr. Brindis, along with the Association of Maternal and Child 

Health Programs, co-authored the 1999 report, Adolescents and the 

State Children’s Health Insurance Program: Healthy Options for Meeting 

the Needs of Adolescents. The study highlighted programs that are 

working to increase teen awareness of SCHIP. Outreach efforts in 

Alabama show that using adolescents to increase awareness to their 

uninsured peers can be a great way to get more teens insured. 

Alabama Targets Adolescents for SCHIP 

In 1998 local pediatrician Dr. Marsha Raulerson worked with 

seven local teens to conduct outreach to other teens in Escambia 

County, Alabama. In 6 months, Raulerson and her group were able to 

decrease the uninsured rate of those using the emergency room at the 

local hospital from 25 percent to 11 percent. “It was really their project,” 

said Dr. Raulerson. “They decided what kind of outreach they wanted; 

we just acted as mentors,” she added. Dr. Raulerson, an administrative 

assistant, and three medical students met with the teens to make sure 

they did things ethically. 

“They were given a list of all the teens who had been to the 

emergency room in the last six months that were uninsured,” said Dr. 

Raulerson. The teens mailed information about Alabama’s SCHIP 

program, ALL Kids, to everyone on the list. Other activities included: 

wearing tee shirts with information about ALL Kids to school; holding meetings with local counselors, encouraging them to spread the 

word about ALL Kids to other adolescents; and setting up a table at a 

local high school that was conducting sports physical exams. 

The program not only increased the number of adolescent enrollees in ALL Kids, but also enticed several teens into health care 

careers. “One of the students who was involved in the project is now 

a third year pre-med student at Alabama State University. Another 

student is in a physical therapy program at Alabama A&M,” said Dr. 

Raulerson. Both students are African American. 

This is important, because as the minority population increases 

the health care industry needs to ensure an ethnically diverse health 

care workforce. “So far, we have done a dismal job in ensuring this,” 

says Dr. Brindis. Role-modeling opportunities like this can have a 

positive impact, she said. 

For more information on adolescents and health care or to obtain a 

copy of Adolescents and the State Children’s Health Insurance Program 

(CHIP): Healthy Options for Meeting the Needs of Adolescents, contact 

Dr. Claire Brindis, National Adolescent Health Information Center 

(NAHIC) at (415) 502-4856. The CHIP report is also available through 

NAHICs website at http://youth.ucsf.edu/nahic.

Office of Minority Health Resource Center U.S. Department of Health and Human Services